Pregledni rad
Guidelines for antiretroviral treatment of adult patients in Croatia in 2009
Josip Begovac
orcid.org/0000-0003-2641-4327
; Klinika za infektivne bolesti DR.Fran Mihaljević, Zagreb
Sažetak
New data about current drugs and arrival of new antiretroviral drugs have prompted us to renew guidelines for antiretroviral treatment in Croatia. We now recommend initiation of treatment to: 1) all patients with symptomatic HIV-infection regardless of the CD4+ cell count per mm3 of blood and to 2) asymptomatic patients with less than 350 CD4+ cell counts per mm3 of blood. In patients with CD4+ cell count lower than 200 cells per mm3 the initiation of treatment should start immediately and in asymptomatic patients with CD4+ cell count between 200-350 cells per mm3 initiation should start after detailed discussion with the patient. We do not recommend initiation of treatment in patients with CD4+ cell count higher than 350 cells per mm3. All HIV-infected pregnant women need to be treated regardless of CD4+ cell count per mm3. Initial treatment should include a non-nucleoside analogue or a ritonavir boosted protease inhibitor and two nucleoside analogues. According to recent clinical trials and drug availability in Croatia an initial treatment with efavirenz or lopinavir boosted with ritonavir can be recommended. We recommend the following nucleoside analogues for initial treatment: zidovudine + lamivudine, abacavir + lamivudine and tenofovir + emtricitabine. Treatment success is defined by achieving a viral load of less than 50 copies of HIV1 RNA per mL of plasma. In case of failure special attention should be given to issues like adherence, resistance and pharmacokinetics. In case of drug failure a drug resistance test is recommended and treatment should, if possible, include at least two new active antiretroviral drugs.
Ključne riječi
adult patients; HIV; treatment
Hrčak ID:
30580
URI
Datum izdavanja:
3.11.2008.
Posjeta: 2.276 *